Jiang Ziying, Yin Xi, Wang Miao, Chen Tong, Wang Yuanyuan, Gao Zhongbao, Wang Zhenfu
Department of Neurology, The Second Medical Center and National Clinical Research Center for Geriatric Disease, Chinese PLA General Hospital, Beijing 100853, China.
Aging Dis. 2022 Jul 11;13(4):1146-1165. doi: 10.14336/AD.2021.1217.
The ketogenic diet (KD) is a low-carbohydrate, high-fat and adequate-protein diet. As a diet mimicking fasting, it triggers the production of ketone bodies (KBs) and brings the body into a state of ketosis. Recent and accumulating studies on humans and animal models have shown that KD is beneficial to neurodegenerative diseases through modulating central and peripheral metabolism, mitochondrial function, inflammation, oxidative stress, autophagy, and the gut microbiome. Complicated interplay of metabolism, gut microbiome, and other mechanisms can regulate neuroinflammation in neurodegenerative diseases by activating multiple molecular and cellular pathways. In this review, we detail the physiological basis of the KD, its functions in regulating neuroinflammation, and its protective role in normal brain aging and neurodegenerative diseases, such as Alzheimer's disease (AD), Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS), and Huntington's disease (HD). We aimed to elucidate the underlying neuroinflammatory mechanisms of KD therapies in neurodegenerative diseases and provide novel insights into their application for neurodegenerative disease prevention and treatment.
生酮饮食（KD）是一种低碳水化合物、高脂肪和适量蛋白质的饮食。作为一种模拟禁食的饮食，它会引发酮体（KBs）的产生，并使身体进入酮症状态。最近对人类和动物模型的研究不断积累，表明生酮饮食通过调节中枢和外周代谢、线粒体功能、炎症、氧化应激、自噬和肠道微生物群，对神经退行性疾病有益。代谢、肠道微生物群和其他机制之间复杂的相互作用可以通过激活多种分子和细胞途径来调节神经退行性疾病中的神经炎症。在这篇综述中，我们详细阐述了生酮饮食的生理基础、其在调节神经炎症中的作用，以及其在正常脑衰老和神经退行性疾病（如阿尔茨海默病（AD）、帕金森病（PD）、肌萎缩侧索硬化症（ALS）和亨廷顿舞蹈症（HD））中的保护作用。我们旨在阐明生酮饮食疗法在神经退行性疾病中的潜在神经炎症机制，并为其在神经退行性疾病预防和治疗中的应用提供新的见解。
